Provider Demographics
NPI:1003653734
Name:MARIENTHAL, NATALIE RAE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:RAE
Last Name:MARIENTHAL
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 STONELEIGH RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-1301
Mailing Address - Country:US
Mailing Address - Phone:815-985-7720
Mailing Address - Fax:
Practice Address - Street 1:2100 W CENTRAL AVE STE 100A
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3817
Practice Address - Country:US
Practice Address - Phone:419-291-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0037053363LF0000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice